Minnesota Wetland Conservation Act Replacement Plan: Complete Application Checklist Local Government Unit (LGU) Applicant Name Address Project Name Date of Application Application Number Check yes or no or leave blank if not applicable: GENERAL APPLICATION REQUIREMENTS Item # Yes 1) 2) 3) No Minnesota Local/State/Federal Application Form for Water/Wetland Projects. The full name, post office address, and telephone number of applicant. For corporations, the principal officers of the corporation, any parent companies, owners, partners, and joint venturers, and a designated contact person. Managing agents, subsidiaries, or consultants that are or may be involved with the activity. The location of project by township, range, section, and quarter section. Evidence of ownership of the project area or the requisite property rights to perform the activity. An accurate map, survey, or recent aerial photograph showing the boundaries of the project area and boundaries, size, and type of each wetland relevant to the activity. A written description of the proposed project and project area, including its areal extent, with sufficient detail to allow assessment of the amount and types of wetland to be affected. 4) 5) 6) 7) 8) FOR THE IMPACTED WETLAND Item # Yes 9) 10) 11) 12) No Square feet or acres of wetland proposed to be impacted by type (Circular 39 and Eggers & Reed). The minor watershed, major watershed, county, and bank service area. A soil survey map of the site showing soil type and identifying hydric soils (where available). A map showing locations of any surface inlets or outlets, natural or otherwise, draining into or out of the wetland and, if the wetland is within the shoreland wetland protection zone or floodplain, the distance and direction to the nearest watercourse. Information concerning the special considerations criteria in MN Rule 8420.0515 (if known or readily available). A list of all other known local, state, and federal permits and approvals required for the activity. 13) 14) Sequencing Analysis: 15) 16) 17) 18) 19) 20) 21) Project purpose and relevant requirements identified, and detailed project description included. Detailed description of project alternatives considered, including: At least 2 project alternatives that avoid wetland impacts described and/or shown (only 1 required for projects that repair or rehabilitate existing infrastructure) Wetland impact minimization efforts identified Description of proposed rectification activities for any temporary wetland impacts (if applicable) Description of BMPs planned to protect wetland functions after project completion (if applicable) Information on the applicability of sequencing flexibility (if applicable as determined by the LGU) FOR THE REPLACEMENT WETLAND WHEN REPLACEMENT IS PROJECT-SPECIFIC Yes No 22) 23) 24) BWSR Forms 7-12-10 The proposed action(s) eligible for credit from MN Rule 8420.0526 is identified. The minor watershed, major watershed, county, and bank service area of the proposed wetland replacement area(s). Evidence of ownership or property rights to the replacement area(s). Page 1 of 2 25) Information concerning the special considerations criteria in MN Rule 8420.0515 (if known or readily available). A description of how the proposed replacement meets the ecological suitability and sustainability criteria under MN Rule 8420.0522, subpart 5. A map showing locations of any surface inlets or outlets, natural or otherwise, draining into or out of the replacement wetland(s) and, if the replacement wetland is within the shoreland wetland protection zone or floodplain, the distance and direction to the nearest watercourse. Scale drawings showing plan and profile views of the replacement wetland area(s). A description of how the replacement area will be constructed; the type, size and specifications of any outlet structures; elevations, relative to mean sea level, of key features; and best management practices that will be implemented to prevent erosion or site degradation. A soil survey map of the site showing soil type and identifying hydric soils (where available) and sitespecific soils information sufficient to determine the capability of the site to produce and sustain wetland characteristics and achieve replacement goals. A timetable that clearly states how and when implementation of the replacement plan will proceed and when construction of the replacement area will be completed. Signed statements by the applicant in accordance with MN Rule 8420.0330, Subpart 3, Item B(11). Evidence that a person proposing to create or restore a wetland within the easement of a pipeline has first notified the easement holder and the director of the Office of Pipeline Safety in writing. A list of all other known local, state, and federal permits and approvals required for the replacement activity. Evidence that any drainage or property rights potentially detrimental to the replacement area have been acquired, subordinated, or otherwise eliminated. A vegetation establishment and management plan according to MN Rule 8420.0528, Subp. 2, Item D. The size, type, and credits expected to result from the proposed replacement actions. 26) 27) 28) 29) 30) 31) 32) 33) 34) 35) 36) 37) FOR REPLACEMENT BY WETLAND BANKING Yes No 38) 39) 40) 41) The account number(s) of the wetland bank where credits are proposed to be withdrawn. The minor watershed, major watershed, county, and bank service area of the bank site. The amount of replacement credits to be withdrawn in square feet. A completed application for withdrawal of replacement credits from the wetland bank(s) or a purchase agreement signed by the applicant and bank account holder. For all replacement plans: 42) A summary description of the required replacement as determined according to the proposed impacts and replacement actions and the replacement standards in MN Rule 8420.0522. Note: If any of the above items are checked “No,” the application is incomplete. For incomplete applications, the LGU must notify the applicant within 15 business days of receipt of the application and list in writing what items or information is missing. If notification is not provided within 15 business days, the LGU must make a decision on the application or work with the applicant to voluntarily withdraw or revise it. The application is: Complete Incomplete For incomplete applications, describe the information needed to make the application complete: Signature: ________________________________________________ Date: ____________________ BWSR Forms 7-12-10 Page 2 of 2